Provider Demographics
NPI:1053843862
Name:NARVAEZ, VINCENT REGINALD FAVOR (MD)
Entity type:Individual
Prefix:
First Name:VINCENT REGINALD
Middle Name:FAVOR
Last Name:NARVAEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5880 LOCHMOOR DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-8506
Mailing Address - Country:US
Mailing Address - Phone:562-343-8014
Mailing Address - Fax:
Practice Address - Street 1:7300 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-3849
Practice Address - Country:US
Practice Address - Phone:888-754-0626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-30
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1840002086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery